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6

Published by
Elets Technomedia Pvt Ltd

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Dr Ravi Gupta Senior Correspondent: Sudheer Goutham B Farhan Khan

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July 2017 | Volume 12 | Issue 07
10
COVER STORY
The Evolution of Public
Healthcare in India
Policymaker’s perspective
14 National Urban Health Mission
An integrated mission for urban
healthcare
Dr K Rajeswara Rao
Joint Secretary, Ministry of Health
and Family Welfare
Government of India
18 Bolstering Growth of AYUSH
Through Quality & Sustainability
Padmapriya Balakrishnan
Deputy Chief Executive Officer,
National Medicinal Plants Board
22 AYUSH: Helping India Achieve its
Health Goals
Dr DC Katoch
Advisor (Ayurveda), Ministry of
AYUSH, Government of India
24 Revamping Public Health
Services in India
Dr Jagdish Prasad
Director General Health Services,
Directorate of Health Services
28 Aiming to Correct Imbalances
In Quality Tertiary Healthcare
Prof (Dr) Nitin Madhusudan Nagarkar
Director, AIIMS Raipur and AIIMS
Bhopal
32
HEALTHCARE INNOVATIONS
e-Hospital: Infusing Efficiency
in Public Health System
industry perspective
36 PSRI Hospital
Where Quality Health Services
is Way of Life
Dr Dipak Shukla
CEO, PSRI
40 Healthcare Delivery
Undergoing Changes at All Levels
Chander Shekhar Sibal
Executive Vice President
Fujifilm India
42 Manipal Hospitals
Dwarka: Seeking Excellence
in Healthcare
Prof Dr Sanjeev Bagai
Director and Dean,
Manipal  Hospitals-Dwarka,
New Delhi
44 NABH: Ensuring Quality Health
Services in India
Dr BK Rana
Director, NABH
Quality Council of India
46 IVH Enabling an Integrated
Tertiary Care Ecosystem
Swadeep Srivastava
Managing Partner
India Virtual Hospital
48 Indogulf Hospital
Closing the Quality Gaps in
Global Healthcare
Dr S Kumar
Managing Director
Indogulf Hospital
50 New Horizons of Growth
for Indian Health Startups
Krishnamurthy Ramalingam
CEO & MD, Galactic Medical
DataBank Private Limited
54 Axio Biosolutions
Saving Lives Through Innovations
Leo S Mavely
Chairman of the Board and
CEO of Axio Biosolutions
57 Universal Hospitals
Where Quality Matters
Dr Shabeer Nellikode
Managing Director
Universal Hospitals, Abu Dhabi
Plot No. 424, CMR Building, Near Govt. School, Metro Pillar No-138, Ghitorni, New Delhi-110030
8

Editorial
India Gearing up for Affordable, Inclusive Healthcare
Public health service in India is undergoing a major transformation.
Driving this change are the fresh policy initiatives by the government and
technological innovations that are touching every aspect of our lives. There
is an urgent need to bolster our efforts to make healthcare more affordable
and inclusive by strengthening the existing infrastructure and bridging the
boundaries to enable smooth flow of information.
Our cover story -- ‘The Evolution of Public Healthcare in India’ -- delves into
the impact of policy change and technology on the healthcare sector, while it
also tries to find solutions to some very pertinent challenges that have been
pestering the healthcare sector in India for long.
Our feature on Healthcare Innovations, ‘e-Hospital: Infusing Efficiency in Public
Health System’, highlights how the country’s most populous state of Uttar
Pradesh has taken a big leap by adopting Information and Communications
Technology (ICT) to infuse a new vitality into the government hospital
network. It underscores the immense potential of the e-Hospital project in
transforming the healthcare delivery in the State which has to grapple with
a multitude of problems, owing to its sheer size and diversity of population.
This Healthcare Leaders Forum (HLF) special issue of eHealth magazine
contains interviews of policy makers like Dr K Rajeswara Rao, Joint Secretary,
Ministry of Health and Family Welfare, Government of India; Dr Jagdish
Prasad, Director General (Health Services), Directorate General of Health
Services; Dr DC Katoch, Advisor (Ayurveda), Ministry of AYUSH, Government
of India; and leading industry captains to help our readers get first-hand
information on various issues, challenges as well as innovations that are
pushing the Indian healthcare sector to reach new heights.
A special focus area of HLF, now in its seventh edition, is to deliberate on
the scope of New Healthcare Policy-2017. Eminent speakers at HLF-2017
will delve deeply into the nitty-gritty of how this policy with private sector
as strategic partners seeks to enable universal health coverage and deliver
quality healthcare services to all at affordable cost.
Looking forward to our readers’ invaluable feedback.

Dr Ravi Gupta
Editior - in - Chief
Elets Technomedia Pvt. Ltd
ravi.gupta@elets.in
 12A

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 10
COVER STORY

The Evolution of Public

Healthcare in India
Policy interventions by the government, coupled with
technological innovations and increasing integration of modern
health services with age-old proven systems are effectively
addressing the pain points of the Indian Healthcare system,
writes Vivek Ratnakar of Elets News Network (ENN).

JUly 2017 | ehealth.eletsonline.com

 12
COVER STORY
The year 2014 marked a watershed
moment in the history of Indian
public healthcare system. The World
Health Organisation (WHO) on
March 27 that year declared India a
polio-free nation -- the fourth WHO
region globally to have achieved
this feat after Americas (1994), the
Western Pacific Region (2000) and
the European Region (2002).
This achievement was made possible
by technological innovations, close
monitoring and relentless efforts of
some 2.3 million polio volunteers,
who worked day and night to reach
every child across the country for
immunisation.
“The government has played a
vital role in the eradication of
small pox, polio, yaws and kidney
worm infestation. This all has been
made possible by a robust public
health system. Even malaria, which
was among the most threatening
endemic diseases in India, is now
on the verge of being eliminated
in the country. We are also trying
to eliminate leprosy at the district
and block levels by 2018-2020,” says
Dr Jagdish Prasad, the Director
General-Health Services, Directorate
of Public Health Services, Ministry
of Health and Family Welfare.
The public health sector in India is
undergoing a tremendous change
driven by forward looking policy
initiatives, technological revolution
that is fast closing the gaps in
healthcare delivery system and
increasing integration of traditional
systems of medicine with modern
healthcare to deliver affordable and
inclusive healthcare for all.
Policy Push to Make Healthcare
Affordable for Masses
The National Health Mission
(NHM), India’s flagship health
sector programme with an
JUly 2017 | ehealth.eletsonline.com
“healthi.in
plans to
empower 1.5
million users
to make smart choices about
their health by 2018. To do so,
healthi intends to continue to
invest in improving the efficacy
of our AI (Artificial Intelligence)
based predictive analytics
engine, and to empower
better connectivity and
communication between the
healthcare provider and the
customer through technology.”
Krishna Ulagaratchagan
Co-Founder and CEO
healthi.in
allocation of Rs 26,690 crores for
2017-18, is gradually revitalising
rural and urban health sectors by
providing flexible finances to State
governments. The mission has
four components -- the National
Rural Health Mission, the National
Urban Health Mission, tertiary care
programmes and human resources
for health and medical education.
“The National Rural Health Mission
has brought down the maternal and
infant mortality rate tremendously.
It provides incentives to women
to get their delivery done in
government institutions free of cost,”
states Dr Prasad.
The Ministry of Health and Family
Welfare has also added two new
programmes to its basket under
NHM -- Mission Indradhanush,
which improved immunisation
coverage by over 5 per cent in the
just one year, and the Kayakalp
initiative, which was launched in
2016 to inculcate the practice of
hygiene, sanitation, effective waste
management and infection control
in public health facilities.
India has also deployed nearly
100,00,00 Accredited Social
Health Care (ASHA) workers, who
are playing a transformational
role in the change happening in
Indian healthcare system. They
act as mobilisers for institutional
deliveries, focus on integrated
management of neonatal and
childhood illness and advise on
home based neo-natal care.
The National Health Policy, 2017,
which has the stated vision of
enabling universal health coverage
and delivering quality healthcare
services to all at affordable cost,
looks at problems and solutions
holistically with private sector as
strategic partners.
The policy marks a major shift from
the past in terms of raising public
health expenditure on health to an
unprecedented 2.5 per cent of the
Gross Domestic Product (GDP) in a
time-bound manner.
The policy also recommends
mainstreaming the traditional health
systems by leveraging the potential
of AYUSH through co-location in
public facilities.
Technology as a Change Agent
“Two significant transformations
are currently underway in the
Indian healthcare sector: the
increasing adoption of technology
in clinical practice and a systematic
effort to prevent chronic diseases.
However, both these efforts are
in their infancy,” says Krishna
Ulagaratchagan, Co-Founder and
CEO of healthi.in.
For technology, its use in clinical
practice is primarily limited to the
front office with practices such as
appointment scheduling and billing.
For the latter in India, it is mostly
limited to health checks. Though

people are more aware and go for
regular health checkups, there is
still a bit of disconnect, according to
Ulagaratchagan.
As per Nilesh Aggarwal, Co-
Founder, eMediNexus and COO,
IJCP Group, technology has touched
every aspect of human life.
“This is true of the healthcare sector
as well. Even till a few years back,
India’s healthcare sector was lagging
behind in terms of technology
adoption. However, the recent
times have brought in some much-
needed development. The union
of technology and healthcare has
opened up new avenues to address
a multitude of issues. From storing
medical records to diagnostic
and therapeutic methodologies,
technology is revolutionising the
healthcare delivery system in the
country,” he observes.
The growth and change in India’s
healthcare industry is being driven
“Grow Fit
intends to
become a
comprehensive
daily health companion for
its consumers. We recently
raised Series A funding of
$ 4.5 million from MEMG
(Manipal Education and
Medical Group), the PE arm of
the Manipal Group. The SAR
Group and The Grover Trust,
Grow Fit’s seed investors, also
participated in this round.
With this, we will now focus
on introducing new product
lines and invest more in
data science and Artificial
Intelligence.”
Jyotsna Pattabiraman
Founder & CEO
Grow Fit
by increasing population, rising
incomes, changing lifestyle, easier
access to high-quality healthcare
facilities, and greater awareness of
personal health and hygiene, adds
Jyotsna Pattabiraman, Founder and
CEO, Grow Fit.
“The private sector has been another
driving force behind the growth in
the Indian healthcare sector. Indian
healthcare providers are increasingly
adopting new technologies to offer
better healthcare services, reach
inaccessible regions, and improve
operational efficiency. Medical
experts are opting for telemedicine
as a way to reach rural India and
create a network of health service
providers. There is rapid growth
in telemedicine and mobile-
based healthcare as well,” says
Pattabiraman.
Overcoming Challenges for a
Healthy Future
While India is doing well in terms
of tertiary healthcare with rising
medical tourism and establishment
of large hospital chains, primary
healthcare still remains a matter
of concern, says Pattabiraman of
Grow Fit.
“In the future, healthcare will be
delivered through small, connected
devices which can communicate
with mobile phones. The union
of technology and healthcare has
opened up new avenues to address
a multitude of issues. From storing
medical records to diagnostic
and therapeutic methodologies,
technology is revolutionising the
healthcare delivery system in the
country,” says Nilesh Aggarwal.
According to Ulagaratchagan of
healthi.in, a healthcare scenario
where wellness behavioural data and
historical health data is accurately
13
COVER STORY
“eMediNexus
is a content-
focused
appthathelpsin
keeping doctors updated with
the latest advancements and
clinical cases in medicine so
that they can improve their
knowledge, diagnose, and treat
patients more efficiently and
with more precision. It also
gives the doctors an option
to take second opinions from
other practitioners on the go
thereby reducing the need
for the patient to be referred
to an already overburdened
doctor.”
Nilesh Aggarwal
Co-Founder, eMediNexus and
COO, IJCP Group
recorded, owned, and managed
by the patient and shared with the
healthcare professionals is the need
of the hour.
“There is a need to make the process
of identifying the right preventive
health exercise unintimidating;
provide choices that factor in the
user’s unique needs; and present
easy-to-understand results that
answer three simple questions: how
healthy am I? What do I continue/
change in order to get and stay
healthy? And who can help?”
“A combination of scientifically
validated predictive analytics,
machine learning technology,
user-friendly design, strong
partnerships with healthcare majors
and cutting-edge research can
make the preventive health journey
personalised and ‘one-size-fits-one’,
and thereby insightful, engaging,
and effective,” he adds.
ehealth.eletsonline.com | JUly 2017
 14

National Urban
POLICYMAKER’S perspective

Health Mission
An integrated mission for
urban healthcare
The National Urban Health Mission has made a considerable
progress since its inception and currently employs more than
24,000 personnel. Besides, more than 4,000 urban Primary Health
Centres are delivering comprehensive healthcare in urban areas,
says Dr K Rajeswara Rao, Joint Secretary, Ministry of Health and
Family Welfare, Government of India, in conversation with Gautam
Debroy of Elets News Network (ENN). Excerpts:

Dr K Rajeswara
Rao
Joint Secretary, Ministry of
Health and Family Welfare,
Government of India

Q You are leading the National

Urban Health Mission (NUHM).
Tell us about the key initiatives
launched by the Ministry of Health
and Family Welfare under the
mission.
The National Urban Health
Mission (NUHM) was launched in
2013, covering all the cities and towns
with more than 50,000 population
and district and State headquarters
with more than 30,000 population.
Since its launch, the mission has
made considerable progress and we
currently have more than 24,000
personnel consisting of medical,
paramedical and programme
management resources. Under
NUHM, more than 4,000 urban
primary health centres are delivering
comprehensive healthcare in urban
areas across the country. Community
involvement is being ensured through
54,000 ASHAs (Accredited Social
Health Activists) and more than
59,000 Mahila Arogya Samities have
already begun operations.
Guidelines and brochures for
various thematic areas like
vulnerability mapping, capacity

JUly 2017 | ehealth.eletsonline.com

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 16
POLICYMAKER’S perspective

building framework, quality
assurance, Auxiliary Nurse
Midwifery guidebook, medical
college collaborations, community
process, Information Education
Communication (IEC) and Behaviour
Change Communication (BCC) have
been issued to all the States and the
Union Territories (UTs).
Joint meetings and video conferences
with all the 35 States and UTs
ware held in February this year to
focus on convergence with other
programmes and departments like
National Urban Livelihoods Mission
(NULM), Housing and Urban
Poverty Alleviation (HUPA), Swachh
Bharat Mission (SBM) and Ministry
of Urban Development (MoUD) to
address issues linked to the social
determinants of health.
letter has already been issued to the
state principal secretaries (health and
family welfare).
Q Which is the nodal agency for
implementation of NUHM in
States and cities?
Flexibility has been given to
the states for implementation of
NUHM either through the Health
Department or urban local bodies,
except for the seven metro cities
where implementation will be
through the urban local bodies
only. A bipartite MoU regarding the
implementation of the NUHM will
be entered between the SHS (State
Health Society) and urban local
body with the provision of periodical
reporting and review of the progress.
them essential primary healthcare
services and reducing their out-of-
pocket expenses for treatment. This
will be achieved by strengthening
the existing healthcare service
delivery system, targeting the people
living in slums and converging
various schemes relating to wider
determinants of health like drinking
water, sanitation, school education,
etc. implemented by the Ministries
of Urban Development, Housing and
Urban Poverty Alleviation, Human
Resource Development and Women
and Child Development.
As NUHM programme has multiple
stakeholders, particularly in the
metros where implementation is
through urban local bodies, often
coordination and collaboration
becomes a challenge. To address

National and State-level workshops Q What are the challenges for

National Urban Health Mission?
some of these challenges, NUHM
is undertaking a series of training
for municipal corporations, urban programmes for senior and mid-level
local bodies, on community The National Urban Health officers of Health Department and
processes, quality assurance, public Mission envisages addressing sensitisation workshops of elected
private partnership, orientation of healthcare needs of the urban representatives of urban local bodies
State Institutes of Health and Family population, with focus on the urban and their functionaries. These are
Welfare (SIHFW) and State Health poor and special emphasis on slum being organised through premier
System Resource Centres (SHSRC) population, by making available to institutes like Indian Institute of
have been organised from time to
time to facilitate the implementation
process of the programme across
the country. To focus on the quality
parameters, Kayakalp Award Scheme
is to be implemented in all the urban
health facilities.

NUHM has also organised

sensitisation workshops with medical
colleges to leverage the existing
provisions of Medical Council of
India (MCI) guidelines, wherein they
are mandated to run urban health
training centres. These centres can
be utilised for providing training,
curative and referral services.
Involvement of Nursing Council
under NUHM by deploying nursing
students for six-eight weeks in urban
health facilities is also encouraged.
In this regard, a Demi Official (DO)

JUly 2017 | ehealth.eletsonline.com


Management (Ahmedabad) and
The Advertising Standards Council
of India (ASCI) with the support of
Asian Development Bank (ADB).
Letters have been sent by the
Minister for Health and Family
Welfare, Government of India
to Chief Ministers and Urban
Development Ministers of the
States. The Joint Secretary (UH)
has also written/communicated
to Mayors of all major cities or
towns regarding the key thrust
areas (mapping of urban vulnerable
population, HR augmentation, service
delivery through proximal UPHC/
UCHC, convergence, community
participation outreach activities,
financial strengthening, etc.) for
accelerating the implementation
NUHM.
Capacity building of human resources
under NUHM, and especially
service delivery functionaries in
soft skills, communicable and non
communicable diseases, dealing with
social and psychological issues, is also
being undertaken.
Q The Government of India is
coming up with a National
Health Protection Scheme. Give
us a brief idea about it.
The National Health Protection
Scheme was announced by the Prime
Minister on 15th August to provide
coverage to the poor and vulnerable
section. The contours of proposed
National Health Protections Scheme
(NHPS) are under consideration of
the Cabinet and approval on the same
is awaited.
Q What is the success rate of
Rashtriya Swasthya Bima Yojana
(RSBY)?
RSBY is a cashless health insurance
scheme which provides annual
coverage of Rs 30,000 to a family of
five through a biometric smart card.
It targets Below Poverty Line (BPL)
households and 11 other defined
categories of unorganised workers.
An add-on health insurance cover
for senior citizens as a top up over
the existing RSBY scheme is being
implemented since 1st April last year.
The scheme covers every senior
citizen, providing additional coverage
of Rs 30,000 per senior citizen in the
RSBY enrolled families.
During 2016-17, RSBY is being
implemented in 15 states, while
SCHIS is being implemented in
eight states. More than 3.63 crore
families with more than 12.6 crore
persons are covered under RSBY.
More than 1.5 crore beneficiaries have
availed hospitalisation benefits since
inception of the scheme.
Q What are Ministry of Health
and Family Welfare’s plans to
develop the health sector in
North-Eastern States?
An outlay of Rs 752.05 crore has been
earmarked for the current financial
year 2017-18 under NUHM. The
funds will be transferred to the states
through the treasury route to the state
health societies on the basis of the
Programme Implementation Plans
(PIPs) approved by the Government
of India.
Both RSBY and NUHM are centrally-
sponsored programmes with majority
of funding from Government of
India.
The premium of RSBY is being
shared between the Centre and the
states in the ratio of 60:40, while
in case of north-eastern states
and three Himalayan states the
premium is shared between the
Centre and the States in the ratio of
90:10 respectively. In case of Union
Territories, the premium is fully
borne by the Government of India.
17
POLICYMAKER’S perspective
Flexibility has been
given to the states
for implementation
of NUHM either
through the Health
Department or
urban local bodies,
except for the seven
metro cities where
implementation
will be through the
urban local bodies
only.
Special support has been provided
to the states of Assam, Nagaland and
Tripura through technical experts
to enhance the capacity of the state
machinery by this ministry with the
support of German Development
Cooperation, GIZ.
Ministry officials are doing regular
interactions for discussion on
NUHM issues, such as finance and
other operational issues. Orientation
workshop on NHM/NUHM PIP
Guidelines was conducted in January
2017 at Guwahati. NUHM workshop
will be conducted shortly for
sensitising state officials and urban
local bodies.
The Government of India always
encourages the north-eastern states
by extending support and hand
holding for better implementation of
the programmes.
ehealth.eletsonline.com | JUly 2017
 18

Bolstering
POLICYMAKER’S perspective

Growth of AYUSH
Through Quality &
Sustainability
Established in the year 2000 to look into the demand and supply
of medicinal plants, policy making and conservation, the National
Medicinal Plants Board under the Ministry of AYUSH has been
playing a leading role in making India a global hub for traditional
medicines by ensuring sustainable, quality and optimum quantity
supply of the raw material to the burgeoning AYUSH industry, says
Padmapriya Balakrishnan, Deputy Chief Executive Officer, National
Medicinal Plants Board, in conversation with Gautam Debroy of
Elets News Network (ENN).

Padmapriya
Balakrishnan
Deputy Chief Executive Officer
National Medicinal Plants Board

Q What are the key objectives of

the National Medicinal Plants
Board?
The main purpose of the National
Medicinal Plants Board is to look
after all the issues related to medicinal
plants in the country. The board
was set up under the Ministry of
AYUSH (Ayurveda, Unani, Siddha
and Homeopathy) with the objective
to ensure that there is a sustainable,
quality and optimum quantity supply
of the raw material to the AYUSH
industry. The board was set up in
the year 2000 to look into the
demand and supply of the
medicinal plants, policy making
and conservation of the medicinal
plants, which are available in
wild conditions. We also support
cultivation of medicinal plants by
offering subsidy to farmers with
forward as well as backward linkages.
We also undertake research activities
related to the medicinal plants.
Q With the government laying
stress on AYUSH, what kind of
promotional activities have you
undertaken to increase popularity of
medicinal plants in the country?
Medicinal plants have been used
in the treatment of many diseases
since time immemorial. Even in
modern medicine, we do not have
cure for many of the illnesses like
cancer or diabetes. Medicinal plants
can be used effectively to cure

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 20
POLICYMAKER’S perspective
lifestyle diseases. Therefore, people
need to be made aware about what
kind of medicinal plants they can
use in their day to day life to keep
away many diseases. We have been
doing promotional activities through
seminars, workshops and training.
Under the advice of Prime Minister’s
Office, we started a 365 day campaign
throughout the country in August last
year. It includes special campaigns,
seminars, workshops, trainings, etc.
Q How do you encourage states to
promote medicinal plants?
We have two schemes through
which we promote medicinal plants.
The first one is the central sector
scheme and the second one is related
to the cultivation of medicinal plants
as a component under the National
AYUSH Mission. Under the central
sector scheme, we allocate projects
for conservation of medicinal plants
and research and development.
We also provide funds to organise
various activities at the state level to
promote medicinal plants. We offer
fund to state governments, research
organisations, departments of the
state government and NGOs to
promote medicinal plants.
For cultivation of medicinal plants,
we give subsidy to farmers. We have
provided around 140 new species
which are highly in demand and need
to be cultivated on a large scale. We
also give funds for nursery, marketing
linkages, processing, storage, etc.
Q How do you ensure protection of
endangered species of medicinal
plants?
There are 60 to 70 ‘red-listed’
species of medicinal plants. These
fall under the rare, endangered or
threatened categories of species.
To ensure that they are protected,
we undertake surveys and create a
200-hectare of MPC (medicinal plant
JUly 2017 | ehealth.eletsonline.com
conservation) reserve inside the forest
area. That particular patch of land
will have high potential of medicinal
plant diversity. For many species
under extinction, we also promote
tissue culture and propagate them on
a large scale. We augment them in the
forest area by carrying out plantation
activities so that instead of one or
two species we have more number of
plants of that species in the forest.
Q Since the Northeast India has
huge potential for medicinal
plants, is there any specific focus
on this region to promote the same?
Around 10 per cent of our budget
is dedicated for northeast. We spend
specifically in northeast and also
allocate funds over and above the
budget for northeast. In partnership
with the Ministry of Development
of North Eastern Region, we have
organised conferences and workshops
to explore the potential of the
northeast region. A lot of medicinal
plants are naturally available in
Northeast India and are being
exploited in unsustainable way. So,
we have to ensure that plants are
exploited in a sustainable manner
and people living in and around
forest areas should be benefitted.
Therefore, we have asked our state
medicinal plant boards in the region
to send us suitable project proposals
that focus on livelihood of the people
and ensure that the rich resources of
Northeast India are utilised for the
betterment of the people.
Q What kind of challenges you
face?
In medicinal plants, there are
many challenges because medicinal
plants in itself is a big subject. There
are 42,000 plant species available
in our country of which 9,000 have
medicinal value. When we assess
the demand and supply, we find
that there are more than 1,000
species that are being traded, of
which more than 200 are traded in
large quantities. Managing all these
varieties is no mean task. Currently,
the supply is majorly coming from
forest areas. However, with the advent
of Forest Dwellers Act [Scheduled
Tribes and Other Traditional Forest
Dwellers (Recognition of Forest
Rights) Act, 2006], it has become
difficult to control the produce that
is being extracted from forests by the
locals. Besides, we have also lost the
opportunity to document that how
much is being extracted from the
forest.
On the cultivation side, marketing,
availability of quality planting
material and grey market of medicinal
plants pose a challenge. There are
many varieties available to farmers,
but since the market price of some of
the species is very high majority of
the farmers often cultivate only those
species and then suddenly the prices
of those species come crashing down.
There are many ‘red species’ that
are governed by various laws and
regulations and their extraction is
considered a crime. So, because of
those particular species medicinal
plants are secretly traded. We are
trying to overcome these challenges.
Q What potential do you see for
AYUSH medicines in the current
scenario?
AYUSH medicines have immense
potential. The Central Council for
Research in Ayurvedic Sciences
(CCRAS) has recently come up with
many prescriptions for diabetes,
migrane, etc. It is part of our rich
tradition that we need to reinvent.
AYUSH medicines have been
documented 5,000 years back. But
for making people to accept the
traditional healing techniques we
need to conduct clinical trials to
prove their efficacy.
 22

AYUSH
POLICYMAKER’S perspective

Helping India Achieve

its Health Goals
With the government policy initiatives giving the AYUSH (Ayurveda,
Unani, Siddha and Homeopathy) a shot in the arm, the traditional
systems of medicine are set to be fully integrated with the healthcare
service delivery system in India. Dr DC Katoch, Advisor (Ayurveda),
Ministry of AYUSH, Government of India, in conversation with Gautam
Debroy of Elets News Network (ENN), talks about the various efforts
being made to further push the growth of traditional methods of
healing and increase their acceptance in public at large.

of Ayurveda (AIIA). This project was

under consideration for long and
now it has been implemented and

Dr DC
the institute has come up near the
Apollo Hospital in Delhi. Although
it is not fully operationalised yet,

Katoch
this will be the apex institute for
referral of patients and also for the
Advisor (Ayurveda) post graduate and post-doctoral
Ministry of AYUSH research in the field of Ayurveda. It
Government of India will also develop collaborations with
foreign institutions.

Q Of late the Ministry of AYUSH is

getting a lot of attention not only
in India but also abroad. What
initiatives have you taken to promote
the traditional methods of healing?
In November 2014, the
Department of AYUSH was upgraded
to the status of a full-fledged ministry.
The big programme that has been
launched by the government for
the promotion of Indian systems of
medicine is the National AYUSH
Mission. Under this mission, we
have launched various programmes
related to the development of
AYUSH sector, particularly for four
things -- for vertical and horizontal
strengthening of AYUSH services; to
strengthen the drug quality control
mechanism; development of AYUSH
teaching institutions; and cultivation
of the medicinal plants. These are
the core activities that are supported
through the National Ayush Mission
to be implemented by the various
states. This programme is aimed
at the overall development of the
AYUSH sector.
Another important initiative that
has been undertaken is to set up
tertiary care apex institutions of
AYUSH, like the All India Institute
Similarly, we are also considering
setting up All India Institute of
Unani Medicine, yoga and All India
Institute of Homeopathy. We already
have the national institutions for
these, but these institutions will have
more focused approach towards
developing the traditional systems
of medicine.
In the area of international
cooperation, we are supporting
establishment of AYUSH chairs in
foreign universities. Since AYUSH
has gone to different parts of the
world, but there is the need of some
scientific activity, creating awareness

JUly 2017 | ehealth.eletsonline.com


about AYUSH, undertake R&D
and help other countries to develop
regulations, standards and put in
place quality control mechanisms.
We have established Ayurveda chairs
in the University of West Indies,
University of Debrecen, Hungary.
Recently, one Ayurveda chair was
declared for a Russian university. A
Unani chair has been established in
the University of Western Cape in
South Africa.
Apart from that we have institute to
institute MoUs at the international
level. Because lot of people want to
know about AYUSH, institutions
associated with it, the courses being
offered and treatment options for
treatment of diseases, so for this
purpose we have set up around 22
AYUSH information cells in our
international missions.
The hardcore scientific activities
undertaken include development
of AYUSH drugs for diseases
like diabetes and other non-
communicable diseases, viral diseases
like chikungunya, dengue, etc. Focus
has also been on developing scientific
base of AYUSH through institutions
like Indian Council of Medical
Research and All India Institute of
Medical Sciences.
Q How the domestic market for
AYUSH is developing in India?
If you see the healthcare delivery
infrastructure in the country, I think
AYUSH has become an integral
part of the system. We have more
than 7,50,000 registered AYUSH
practitioners in the country, around
26,000 government dispensaries,
around 36,000 government AYUSH
hospitals, 565 AYUSH colleges, and
from these colleges more than 30,000
AYUSH doctors and around 3,000
post-graduate AYUSH doctors pass
out every year.
If we look at the industry, around
8,867 licensed manufacturing units
of AYUSH drugs are operational in
the country.
Q How is infrastructure being
developed in the country to
leverage AYUSH in delivering
healthcare services?
Earlier, we were working in
isolation. But now we have started
working in collaboration with the
entire health sector. Under the
National Health Mission, there is a
strong strategy for mainstreaming
of AYUSH. It means making the
optimum use of AYUSH in the
healthcare services. The AYUSH
doctors are also being utilised for
the implementation of the National
Health Mission programmes to
help achieve the health goals of the
country, as also providing health
services to the people.
Around 60-65 per cent of the district
hospitals in the country now also
have AYUSH facilities. Around
18,000 Primary Health Centres and
Community Health Centres also have
AYUSH facilities. The vision is to
grow the number of such facilities so
that the patients have the option to
get the treatment of their choice.
Q What are the key challenges for
mainstreaming of AYUSH?
The main challenge is to gain the
acceptance of traditional systems of
medicine among the people through
evidence of efficacy and quality. We
are seriously working on these issues.
Now we have the Pharmacopoeia
Commission of Indian Medicines
and Homeopathy. These bodies are
responsible for the development of
standards of AYUSH drugs. More
thrust has been given in this area.
I think in near future, we will have
the standards for all the drugs
and ingredients which are used in
23
preparing the medicines.
POLICYMAKER’S perspective
Quality control is also an important
aspect because we cannot leave the
drugs untested. So, for drug testing
we now have laboratories in most
of the states and we are supporting
the states to strengthen their testing
facilities. Even private laboratories
can be recognised under the Drugs
and Cosmetic Rules. Around 45
drug testing private labs have been
included under the Drugs and
Cosmetic Rules and they are acting
just like public labs.
To prove the safety of AYUSH
drugs, lot of scientific work is being
done through our schemes. We are
providing support to the scientific
institutions for validation of AYUSH
drug safety and efficacy. This is the
biggest task, as in our country despite
8,800 AYUSH drug manufacturing
units the problem is that more
than 80 per cent of these units are
of medium and small scale. They
don’t have the wherewithal to invest
in R&D.
Q What role the private players
are playing in the development
of AYUSH sector?
Through various schemes, we are
providing support to private players.
For example, we have a scheme for
developing industry clusters. Under
this scheme, 20-30 players can come
together and set up enterprises with
common facilities for drug storage,
production, testing, certification
etc. In the last few years, around 6-7
industry clusters have been developed
in the country, such as in Amritsar,
Bengaluru, Jaipur, Kerala, etc. Some
more are coming up in various other
parts of the country.
We also have a scheme for developing
AYUSH interventions in public
health.
ehealth.eletsonline.com | JUly 2017
 24

Revamping
POLICYMAKER’S perspective

Public Health
Services in India
Health services are witnessing a paradigm shift in India with the
government making tremendous efforts to close the existing gaps
in healthcare delivery. The Directorate of Health Services under
the Ministry of Health and Family Welfare is at the forefront of this
revolutionary change by making health services more inclusive
and affordable for the poor through a number of initiatives, says Dr
Jagdish Prasad, Director General Health Services, Directorate of
Health Services, in conversation with Shivani Tyagi of Elets News
Network (ENN).

Dr Jagdish
Prasad
Director General Health Services
Directorate of Health Services

Q How is the Directorate of

Health Services impacting the
healthcare delivery in India?
The Directorate of Health
Services is deeply impacting the
healthcare delivery in the country.
The directorate has played a vital
role in the eradication of small
pox, polio, yaws and kidney worm
infestation. This all has been made
possible by a robust health system.
Even malaria, which was among the
most threatening endemic diseases
in India, is now on the verge of being
eliminated in the country. We are
also trying to eliminate leprosy at the
district and block levels by 2018-
2020.
The Directorate not only implements
health programmes, but also does
the surveillance to find out the
gaps, which can be filled by putting
in place workforce and a proper
monitoring system.
Q What steps have been taken
up by the government to
provide affordable health
services to citizens?
Affordable healthcare can be
provided in many ways. One of the
ways was the National Rural Health
Mission started by the Government
of India in 2005. It has brought down
the maternal and infant mortality
rate tremendously. It provides
incentives to women to get their
delivery done in government
institutions free of cost.
Other positive step in this direction is
the provision of essential medicines.
Under this programme, whatever
money is required to purchase
medicines by Primary Health Centres
(PHCs) and district level hospitals to
provide free drugs to the patients will
be contributed by the Government of

JUly 2017 | ehealth.eletsonline.com

 26
POLICYMAKER’S perspective
India, so that the patients in public
hospitals can get the essential drugs
free of cost.
Another initiative we have taken is
the opening of affordable medicine
outlets under the AMRIT (Affordable
Medicines and Reliable Implants
for Treatment) scheme in all the
public hospitals.
Recently, the National Health
Insurance Policy has been launched
for more than 40 million families.
Under this policy, every family will
be given Rs 1 lakh of insurance for
getting treatments done. For elderly
people, Rs 30,000 more will be given
as insurance and they can get their
treatment done in any hospitals either
private or government. The package
is fixed by the government so that it
becomes affordable for the poorest of
the poor people to receive treatment.
Q Which initiatives by you are
directed towards addressing
the growing burden of non-
communicable diseases in India?
JUly 2017 | ehealth.eletsonline.com
Non-communicable diseases–
especially cardio vascular diseases,
diabetes, stroke and respiratory
diseases—are causing more deaths
than communicable diseases in India.
Initially, we started a pilot project in
10 districts of the country to develop
cardiac ICUs, scalding/cascading
for blood sugar and hypertension.
Then we started the project in 100
districts cascading for diabetes
and hypertension. So far, we have
screened about 60 million people
including those above 30 years,
pregnant women and those who have
family history of coronary diseases,
diabetes or hypertension.
Recently, the Government of India
has also launched screening for three
cancers – the cervical cancer, breast
cancer and ovarian cancer.
The training of ASHA and ANMs
has been started so that they can
do the screening. Once any of the
three most common cancers is
suspected, the patients can be referred
to a particular district hospital for
diagnosis and treatment.
Another initiative we have taken is
to eliminate rheumatic heart disease
that is very common in our country.
The Government of India has
allocated Rs 120 crore to develop 20
state cancer hospitals in the country.
The government has also provided Rs
45 crore to upgrade these hospitals.
Rs 120 to 180 crore has been given
to medical colleges to develop super
specialties so that chronic non-
communicable diseases can be
treated locally.
Q What are the technical aspects
of Generic Medicine Code and its
implementation?
Generic is a chemical name,
like crocine is a brand name and
paracetamol is a genric drug. We
need to understand that before any
drug acts on the body, the chemical
has to undergo a process so that
it can become effective. It means
that to reach the target cells, its
concentration in the blood should
reach a particular level for it to be
effective. But presently, the generic

drugs made in the country are not
doing the bio metric and bio efficacy
tests which is a must. That is the
reason why the Government of India
has taken the decision that whosoever
wants to manufacture generic drugs
in the country they have to take bio
metric and bio efficacy certification
then only the generic drugs made by
them can be accepted. We have this in
our agenda that even retrospectively
every generic drug manufacturer
will have to have bio metric and bio
efficacy certification and have to
develop the system in three years
otherwise they have to close their
manufacturing unit.
Q What is your vision to make
healthcare more accessible and
affordable for the citizens?
Availability of doctors is a big
challenge, especially in rural areas.
To ensure the availability of doctors,
the government needs to develop
infrastructure in Primary Health
Centres (PHCs) and Community
Health Centres (CHCs) in rural
areas. Presently, the infrastructure of
health centres is in a very bad shape.
Although a lot of fund has been
given to states under the National
Rural Health Mission to strengthen
the structure of health system public
hospital, still it hasn’t come up to
the level where it can be compared
to any corporate facility. So, the
important challenge is to develop
27
POLICYMAKER’S perspective
good infrastructure for quality health Affordable
services.
healthcare can
The second area we want to focus be provided in
on is medical education. Anybody many ways. One of
who wants to start a new medical
the ways was the
college, they should first run a
300-bedded hospital and at least for National Rural
the first three years the facility should Health Mission
be evaluated on the quality of services started by the
being offered.
Government of
Q What are the technical
challenges for implementation
India in 2005. It has
brought down the
of the Clinical Establishment
Act? How can these challenges be
maternal and infant
addressed? mortality rate
tremendously. It
The idea is to regulate the whole
system of hospitals. We don’t want
provides incentives
to women to get
to control corporate hospitals, but
we want to regulate the system of their delivery done
treatment. The cost of treatment in government
should be defined.
institutions free of
Today, it is very hard to know how cost.
much a hospital is going to charge
when a patient is discharged. So, it
needs to be regulated. The Clinical
Establishment Act will allow us to
have standardisation for healthcare
facilities. For example, after its
implementation if a hospital boasts
of a neuro clinic it will have to ensure
that it has all the basic facilities in
place. The act will not allow a hospital
to display a board of neuro research
centre when it does not have the
facilities of research.
ehealth.eletsonline.com | JUly 2017
 28

Aiming to Correct
POLICYMAKER’S perspective

Imbalances
In Quality Tertiary
Healthcare
AIIMS Raipur and AIIMS Bhopal have been established with an
aim to correct regional imbalances in providing quality tertiary
level healthcare in central India and impart medical education
and training in under-served areas. Prof (Dr) Nitin Madhusudan
Nagarkar, Director, AIIMS Raipur, with additional charge as the
Director, AIIMS Bhopal, in conversation with Arpit Gupta of Elets
News Network (ENN), highlights the key steps taken so far to
improve the health delivery system and future growth plans.

Prof (Dr) Nitin

M Nagarkar
Director
AIIMS Raipur & AIIMS Bhopal

Q What are the key healthcare

services offered by AIIMS Raipur
and AIIMS Bhopal? How do you
ensure quality of these services?  healthcare in the country and attain
AIIMS Raipur and AIIMS Bhopal
are among the six All India Institutes
of Medical Sciences established by the
Ministry of Health and Family Welfare,
Government of India, under the
Pradhan Mantri Swasthya Suraksha
Yojna (PMSSY). The initiative aims
to correct regional imbalances in
providing quality tertiary level
self-sufficiency in graduate and
postgraduate medical education and
training in under-served areas of the
country. AIIMS Raipur and AIIMS
Bhopal offer healthcare services
pertaining to all the broad specialities,
both medical and surgical.
The hospital attached to the AIIMS
Raipur has a multi-speciality OPD.
The hospital’s current capacity is
400 beds, which is projected to
expand to 960 in the near future. It
also has functional state-of-the-art
Operation Theatres (OTs). With
the commissioning of all blocks of
the hospital, the number of OTs
is planned to be increased to 30.
Surgeries – both major and minor –

JUly 2017 | ehealth.eletsonline.com

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POLICYMAKER’S perspective
are being performed in the hospital
on a routine basis. In fact, AIIMS
Raipur also boasts of the first open
heart surgery having been done
among the six new AIIMS.
The institute offers diagnostic
services in pathology, microbiology,
biochemistry and radiology. AIIMS
Raipur has digital radiology unit,
a mammography unit, an OPG
(orthopantomogram) set-up, CT
(computed tomography) scan
and DSA (digital subtraction
angiography). MRI (magnetic
resonance imaging) is in the process
of being installed and will be
functional soon.
Similarly, AIIMS Bhopal has the
latest CT and MRI machines. All
the laboratories have the latest and
the best equipment. Patients coming
to AIIMS Raipur and Bhopal can
purchase medicines at a discounted
price from the AMRIT (Affordable
Medicines and Reliable Implants for
Treatment) pharmacy located within
the campus near the hospital building.
The institutes also offer services
in AYUSH systems of medicine.
These services will complement the
allopathic system of medicine offered
to the patients.
Monitoring mechanisms are in place
in every department and facility to
ensure that quality is maintained in
delivering healthcare services. Faculty
members are encouraged to visit
other places within the country and
abroad so that the best facilities can
be replicated and offered to the public
of central India.
Q AIIMS Delhi has emerged as the
centre of excellence for medical
learning and healthcare research
in India, how do you plan to have high
quality medical care and teachings
along with focus on research?
The mission statement of AIIMS
JUly 2017 | ehealth.eletsonline.com
Raipur includes excellence in medical
education, training and research.
The institute has an excellent central
library spread over three floors
covering about 15,000 sq ft floor area.
The top floor of the library houses the
state-of-the-art e-library and journal
section. Around 5,000 medical and
nursing books and about 500 books
of general reading are available in
the library. The institute subscribes
to around 400 journals. The Wi-Fi
internet facility is available on all
three floors of the library.
AIIMS Bhopal has an excellent library
housed in a separate building. AIIMS
Raipur provides robust infrastructure
and a conducive atmosphere to
facilitate research. Both institutes
already have received permission for
starting MD (Doctor of Medicine)
and MS (Master of Surgery) courses
in few specialities. More seats will
be added with induction of faculty
and expansion of infrastructure
and services. MD/MS students will
have mandatory hands on training
in research methodology. The
institutions will have their own PhD
courses. Intramural seed grants are
being given to faculty members on
competitive basis.
AIIMS Raipur
Senior faculty members monitor
these activities. Faculty research
presentations are planned to be held
once a month on rotational basis.
Extra-mural research grants will be
solicited and cross country research
promoted. The institutes already have
institute ethics committees to monitor
and facilitate research. A Department
of Biostatistics, Clinical Epidemiology
and Clinical Research Secretariat will
be established to facilitate all round
research in all the departments. This
department will proactively help the
faculty and researchers to design
research projects, research proformas,
data analyses, maturation of research
hypotheses, assistance in clinical and
field trials and collaborations.
Q Which innovations you seek to
introduce in AIIMS Raipur and
Bhopal to improve healthcare
delivery? How is information
technology bringing efficiency to
your operations?
AIIMS Raipur and Bhopal
have introduced online registration
and appointment facility for the
benefit of patients. Patients can
take appointments as per their
convenience and spare themselves

the difficulty of having to stand in
long queues. The institutes have also
started preparing and maintaining
electronic health records of the
patients, thus making retrieval and
referral just a few clicks away.
Telemedicine OPD services
were started by AIIMS Raipur in
collaboration with the CRPF on
April 2, 2013. The services are being
provided twice a week on every
Monday and Thursday. This service
specifically caters to the population
in remote and inaccessible areas of
Chhattisgarh, especially LWE (Left
Wing Extremists) affected areas.
Both these institutes have focussed on
public health issues relevant to their
geographic regions like malnutrition,
sickle cell anaemia and head and
neck cancers.
The institutes strive to make all
relevant information available to the
general public on their websites. Plans
are underway to introduce public
lectures. Eminent speakers will be
invited to talk on topics of public
interest pertaining to health.
AIIMS Bhopal
Q Since its establishment in 2012,
AIIMS Raipur’s bed strength
has increased to almost 400
now, and by the end of this year it is
expected to reach 960 beds. What are
your future plans?
The Standing Finance Committee
(SFC) of the Institute has approved
the setting up of a School of Public
Health (SPH) under AIIMS, Raipur.
Centres of Excellence for cardiac
care, neurosciences, nephrology and
oncology have already been approved
by the Government of India to be
developed in the hospital complex in
Tatibandh. A Tribal Health Research
Centre and a School of Tropical
Medicine are also planned to be
started in the future.
With increasing infrastructure
and induction of more staff the
institute will require to add the
available housing units in its
residential campus at Kabir Nagar,
Raipur. HSCC (India) Ltd. has been
nominated to prepare DPR (detailed
project report) for this housing
project (phase – II) for 191 units for
Rs 100 crore.
31
POLICYMAKER’S perspective
The Standing Finance
Committee (SFC) of
the Institute has
approved the setting
up of a School
of Public Health
(SPH) under AIIMS,
Raipur. Centres
of Excellence
for cardiac care,
neurosciences,
nephrology and
oncology have
already been
approved by the
Government of India
to be developed in
the hospital complex
in Tatibandh.
Q Where is Indian healthcare
system headed in view of
the recent initiatives by the
government and the industry? 
In the Union Budget 2017-18,
the overall health budget has been
increased to 2.27 per cent of the total
Budget. In addition, the Government
of India has brought down the prices
of various implants and is pushing
for prescription of generic drugs.
The government is also encouraging
the healthcare industry to produce
equipment, infrastructure, implants,
etc. locally under its ‘Make in
India’ campaign. These and other
initiatives of the government ensure
that the rising cost does not become
a stumbling block for availing
quality healthcare services by the
common man.
ehealth.eletsonline.com | JUly 2017
 32
Healthcare Innovations

e-Hospital:
Infusing Efficiency
in Public
Health System
Uttar Pradesh’s healthcare system has taken a big leap by using Information and Communications (ICT)
technology to infuse a new vigour into the government hospital network across the state. The e-Hospital
project developed by the National Informatics Centre is set to take the service delivery in the state-run
hospitals to a completely new level, writes Arpit Gupta of Elets News Network (ENN).

U
ttar Pradesh is in the process
of developing an Integrated
Health Information
Platform (IHIP) under the guidance
of Ministry of Health and Family
Welfare, Government of India.
Electronic Health Record (EHR)
is the key to develop IHIP. The
National Informatics Centre has
developed e-Hospital which is
being implemented in 30 district
level hospitals of the state in
two phases.
and e-blood bank modules of
the e-Hospital project have been
operationalised. The State has
requested the Government of India to
add diagnostic and clinical modules
too in the software so that complete
information of patient is captured in
the EHR. It is expected that by the
end of July 2017 all modules will be
fully operational.
Apart from the three Lucknow
hospitals, the process of integration
of 27 hospitals of UP on e-Hospital
portal has been initiated. It is
expected that by the end of October
2017, these hospitals will start using
e-Hospital software. The 27 hospitals
of the State that have been included in
the project include district hospitals
of Agra, Azamgarh, Bareilly, Basti,
Faizabad, Gonda, Gorakhpur,
Jhansi, Mirzapur, Banda, Etawah,
Moradabad and TB Sapru Hospital-

In the first phase, three hospitals

of Lucknow were selected for the
e-Hospital project implementation.
E-hospital has been functional at
Ram Manohar Lohia Hospital since
April 17, 2017 and at Shyama Prasad
Mukherji (Civil) Hospital since May
1, 2017. The Balrampur Hospital in
the state capital is also likely to start
using e-Hospital very shortly.

Initially the online registration

system, out-patient department,
in-patient department, billing

July 2017 | ehealth.eletsonline.com

 34
Healthcare Innovations
Allahabad, UHM Hospital-Kanpur
Nagar, PL Sharma Hospital-Meerut,
SBD District Hospital Saharanpur,
Pt. Deen Dayal Upadhyaya District
Combined Hospital-Aligarh, Pt.
Malkhan Singh District Hospital-
Aligarh, Manyavar Kanshi Ram
Hospital-Kanpur Nagar, SSPG
Division and District Hospital-
Varanasi, LBS Ramnagar Hospital-
Varanasi, Moti Lal Nehru District
Hospital-Allahabad and LBRN
Combined Hospital in Lucknow.
Alok Kumar, Secretary, Health
and Family Welfare Department,
and Mission Director, National
Health Mission, Uttar Pradesh
said that ‘MeraAspataal’, which is a
unique system to capture the patient
feedback, will also be linked to the
hospitals which will start using
July 2017 | ehealth.eletsonline.com
the e-Hospital system. Using the
‘MeraAspataal’ dash board, one can
see what kind of services are being
rendered by hospitals and if the
patients are satisfied with the quality
of services given by the hospitals.
He added that the Ram Manohar
Lohia Hospital and Shyama Prasad
Mukherji Hospital have been linked
with ‘MeraAspataal’ and very
soon all hospitals will be linked to
‘MeraAspataal’.
Kumar also informed that Aadhaar
number has been linked with the
online registration system and now
the facility of online registration
is also available in RML and Civil
hospitals. Separate counters have
been provided for patients registered
using ORS.
(Left) Alok Kumar, Secretary,
Health and Family Welfare
Department, and Mission Director,
National Health Mission, Uttar
Pradesh, being falicitated for his
achievements by Peeyush Kumar,
Joint Secretary, DBT, Government of
India, at the Smart City Summit Uttar
Pradesh.
As mobile phones have emerged
as an affordable and convenient
interface between the patient and the
doctor, the government has decided
to facilitate booking of doctors’
appointments on mobile phones in
around 100 state-run hospitals in
Uttar Pradesh.
According to Union Minister of
Law and Justice and Electronics
and Information Technology Ravi
Shankar Prasad, this and other
facilities will soon be brought on the
e-Hospital platform.
“Uttar Pradesh, with the Centre’s
help, will link 100 hospitals under the
‘e-Hospital’ scheme within the next
six months,” he said recently.
“The e-Hospital services will be made
available, under which people can
seek an appointment with doctors
using their mobile phones. Around
100 government hospitals in the state
will be brought on the platform of
e-Hospital in the next six months,”
Prasad said.
This will prove to be a game changer
as given the deep penetration of
mobile phones in the state, healthcare
will be easily accessible for millions of
people across the state and the health
delivery can be made more efficient.
 36

PSRI Hospital
industry perspective

Where Quality Health

Services is Way of Life
Pushpawati Singhania Hospital and Research Institute (PSRI)
in Delhi is known for its state-of-the-art facilities in medical
and surgical disciplines. Ethics in clinical practice and patient-
friendly work culture are high on the agenda of the institute in all
its plannings and activities, which makes it a preferred choice for
patients and employees, says Dr Dipak Shukla, CEO, PSRI.

Dr Dipak
Shukla
CEO, PSRI Hospital

P
SRI Hospital is a nationally
and internationally reputed
tertiary healthcare institution
promoted by JK Organisation.
The institute started functioning
in 1996 with the super specialities
of gastroenterology, GI surgery,
nephrology and urology including
kidney transplant surgeries. In
due course of time, specialities of
general medicine, general surgery,
gynaecology, ENT, psychiatry and
clinical psychology, etc., were added.
Recently, institute has added
cardiac sciences, neurosciences,
orthopaedic and joint replacement
and liver transplant programme as
the new four super specialities to
the institute. With this addition,
PSRI has grown to become a 204-
bed capacity hospital, including 42
beds for critical care and eight beds
for emergency.
As such, institute is known for its
state-of-the-art facilities in medical
and surgical disciplines and is
situated in the serene ambience of
South Delhi. It has a lot of lush-
green surroundings for soothing and
early repercussion of patients.
Ethics in clinical practice and
patient-friendly work culture are
high on the agenda of PSRI in all its
plannings and activities. The institute
is also known for exceptional
employee-friendly work culture.
Many employee welfare activities
are an integral part of the activity
calendar of the institute. There is
a structured system for periodical
assessment of work performance
of employees at all levels and to

JUly 2017 | ehealth.eletsonline.com

 38
industry perspective
develop purposeful class leadership.
Best employees are identified and
awarded on quarterly basis at all
levels. This approach has been very
effective in employee motivation,
employee retention and minimum
employee turnover in all the
categories, including nurses.
Since inception of the institute,
there has been a thrust on regular
professional and academic activities
as a whole and for the doctors as well
as the nurses in all the departments
in particular. PSRI has a wonderful
well-equipped library to aid teaching
and training programmes for
post-doctoral teaching, for which
the institute is recognised by the
National Board of Examination.
PSRI is fortunate to have
internationally known clinicians and
teachers in the chosen specialities
of the institute, who have been the
driving force behind the high quality
academic activities and research
at the institute. The institute has
a provision of financial grants for
the exceptional performers in their
research activities and that too
if they have publication of their
research work in international
journals of their speciality.
JUly 2017 | ehealth.eletsonline.com
To promote research, a well-
structured research department
headed by director research is
in place. There is an advisory
committee of the institute which
is responsible to monitor and
drive original research as well as
clinical research in all the clinical
departments of the institute. The
institute has a proper and well
defined ethics committee to approve
and monitor various research
projects which are presented
before it from time to time.
This research ethics committee
has been constituted as per the
ICMR guidelines.
The institute also has a focus for the
environment protection and energy
conservation. Well planned water
harvesting system, highly advanced
and sophisticated sewage treatment
plant and effluent treatment plant.
Solar panels for hot water provision
and the latest technology for energy
conservation is an integral part of
the hospital and support services.
Patient satisfaction levels are
quantified by 100 per cent
confidential feedback of in-patients
admitted to various categories of
beds from time to time. Very focused
PSRI has a
wonderful well-
equipped library
to aid teaching and
training programmes
for post-doctoral
teaching, for which
the institute is
recognised by the
National Board of
Examination.
and personalised attention is given to
the patients’ feedback for improving
hospital services and enhancing
patient satisfaction. On account of
very high patient satisfaction levels,
patients come from far and wide
to PSRI.
The institute has also been very
sensitive for the health promotion
of the nearby population through
free health camps, health talks and
various health awareness activities.
In nutshell, it may be said that PSRI
has been unique in developing
highly ethical, professional and
patient-friendly work culture as a
tool for driving changes in the health
care sector of Delhi and India as a
whole. PSRI doctors and employees
feel proud to be members of the
PSRI family.
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 40

Healthcare
industry perspective

Delivery
Undergoing Changes
at All Levels
The healthcare industry in India is gathering momentum with focus
shifting on improving healthcare infrastructure, digitalisation of
hospitals and policy interventions, leading to increase in efficiency
of service delivery, writes Chander Shekhar Sibal, Executive Vice
President, Fujifilm India.

The Goods and Services Tax (GST)
is going to be a key enabler of
making ‘one India one tax’ and this
would lead to increase in efficiency
and reduce wastage in supply chain
management. Healthcare delivery
in India is now uniquely composed
to undergo a change at all its stages
-- prevention, diagnosis, and
technologies which give exceptional
image quality at lower dose and
enhancing efficiency of point of
care x-rays.
In this era of digitisation, the quality
of workflow is getting better; and
the efficiency of people is increasing
in the hospitals. With the help of

Chander
treatment. Government is taking technological advancement, doctors
many steps towards improvement are able to manage workflow
of healthcare sector by promoting systems and are able to treat more

Shekhar Sibal routine and proper screening health

education programmes in tier
Executive Vice President, 2 and 3 cities.
Fujifilm India
Our focus is on tier 2 and tier 3 cities
patients. Healthcare is reaching to tier
3 cities and capturing villages where
various screening programmes are
being initiated by the government for
healthy India.

T
he healthcare market in India
is growing at a rapid pace
and the government hospitals
and State governments through
Private Public Partnerships (PPP)
are trying to improve the healthcare
infrastructure, including digitalisation
of X-ray. Teleradiology and Picture
Archiving and Communication
System (PACS) are becoming
necessity due to huge patient load
and less number of doctors.
and in the process of digitisation
happening in the medical industry.
Most of the time, the government
projects are delayed which is a hurdle
for us as we are going through Public-
Private Partnerships. But I believe,
with the help of GST we can be in
a better position like transporting
products within the country. This
would also help in reducing the
warehouse and transportation cost.
Buyer wants faster services and new
Recently, the government has
also come up with a new policy
where preventive healthcare is very
important. It’s better to be healthier
than falling sick as that expenditure is
huge. We need to focus on hospitals
expenditure to be more equipped
with better technology. Digitisation is
the trend and it will go further, better
quality equipment would bring more
work flow, which will bring better
quality, workflow.

JUly 2017 | ehealth.eletsonline.com

www.skydomedesigns.com
 42
industry perspective

Manipal Hospitals
Dwarka: Seeking
Excellence in Healthcare
Guided by the belief and triad of core values of clinical excellence,
patient centricity and ethical practices, Manipal Hospitals-Dwarka
in Delhi, which is due to launch and go live by October 2017, seeks
to become one of the best and most trusted healthcare providers
in the country, says Prof Dr Sanjeev Bagai, Director and Dean,
Manipal  Hospitals-Dwarka, New Delhi.

Prof Dr Sanjeev
Bagai
Director and Dean
Manipal  Hospitals-Dwarka, New Delhi

Q What are the key healthcare

services offered by your
hospital? How do you ensure
quality?  We seek to achieve clinical excellence
Manipal Hospitals-Dwarka is part of
the Manipal Education and Medical
Group (MEMG), a pioneer in the field
of education and healthcare delivery
in India. The 480-bed hospital with as
many as 40 specialities and 75 super-
children care, pediatric intensive care
unit, neonatal intensive care unit, etc.  Q
through an excellent team of doctors,
medical specialists who are well versed
with the latest advancements in their
respective field of medical expertise.
Q How is Information Technology
bringing efficiency to your
Which innovations you seek to
introduce in your hospital to
improve healthcare delivery to
patients?
Clinical real-time technology, data
analytics, digital online registration
systems etc, are some of the key
innovations we plan to introduce in
Manipal Hospital-Dwarka.  

specialities, is due to launch and go live

by October 2017. 
The hospital will have centres of
excellence in all major departments
including cardiac sciences, orthopedics
and joints, neurology sciences,
critical care, gastroentrology, GI
surgery , oncology medicine,
radiation oncology, onco surgery,
general surgery, minimal invasive
lap surgery, renal sciences, urology,
renal transplant, liver transplant,
plastic surgery, ENT, ophthalmology,
reconstructive surgery, women and
operations?
We have a sharp focus on digital
smart technology in order to achieve
excellence in patient care, ensure best
clinical outcomes, operative excellence,
invasive smart marketing, building
management systems, etc.  telemedicine, international medical
Clearly, this institution is years ahead
of its time when it comes to adopting
technology, artificial intelligence, VT,
tracking, electronic medical records,
real time data analytics, digital
operation theatres, etc. 
Q Where is Indian healthcare
system headed in view of
the recent initiatives by the
government and the industry? 
These are exciting times for
Indian healthcare. Collaborations,
tourism, etc are all unifying our
world. In near future, I see e-health
becoming the real focus for attaining
excellence in healthcare delivery
and making it more affordable and
inclusive.

JUly 2017 | ehealth.eletsonline.com

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 44

NABH
POLICYMAKER’S perspective

Ensuring Quality Health

Services in India
Entrusted with maintaining the basic level of quality of
services in hospitals, the National Accreditation Board for
Hospitals and Healthcare has come up with a number of new
initiatives to develop a robust healthcare delivery system in
the country. Dr BK Rana, Director, NABH Quality Council of
India, highlights the quality standards and various compliance
related challenges for hospitals in conversation with Elets
News Network (ENN).

Ministry of Tourism and Services

Export Promotion Council. In the
AYUSH (Ayurveda, Unani, Siddha
and Homeopathy) sector, we have

Dr BK
started accreditation programme for
‘Panchakarma’ daycare centres.

Rana
Q What are the key accreditation
standards have you fixed for
AYUSH hospitals and wellness
Director, NABH centres? 
Quality Council of India
We have five different set of
standards under AYUSH to cover
all the five streams. The second
edition of these standards has put

Q What are the new initiatives

National Accreditation Board
for Hospitals and Healthcare
(NABH) has undertaken to ensure
quality health services get
delivered?
Currently, NABH offers 15
different accreditation/certification
programmes for a range of
healthcare facilities. Under the
new initiatives, pre-accreditation
entry level certification programme
was started to ensure a basic
level of quality in hospitals. This
programme is being used by those
private hospitals offering cashless
treatments for empanelment
purpose. Insurance regulator
IRDA (Insurance Regulatory
and Development Authority) has
mandated it. In addition, NABH
has started an empanelment
programme for medical value
travel facilitators to ensure good
services to patients coming from
abroad. This programme is endorsed
by the Ministry of Commerce,
more focus on clinical care aspects.
Structural requirement, which
used to be a separate book in first
edition, has been incorporated
in second edition at appropriate
places. The requirements of the
standards shall have to be identified;
evidenced by data gathered, analysed
and interpreted with the aim of
improving the quality system of
a hospital. Wherever the word
should is used, it is imperative
that the organisation implement
the same. Where the phrase can/

JUly 2017 | ehealth.eletsonline.com


could/preferably is used the
organisation would use its discretion
and implement it according to
the practicability of the proposed
guidance.
In general, the organisation will need
to establish clear evidence backed by
robust systems and data collection
to prove that they are complying
with the intent of the standards.
These systems are as we say, defined,
implemented, owned by the staff and
finally provide objective evidence of
compliance. Some of the key issues
include:
1. Patient-related: Monitoring safety,
treatment standards and quality
of care. This would mean to
effectively meet the expectation
of patients and their families and
associates.
2. Employee-related: Monitoring
competence, on-going training,
awareness of patient requirements
and monitoring employee
satisfaction.
3. Regulatory-related: Identifying,
complying with and monitoring
the effective implementation of
legal, statutory and regulatory
requirements which affect patient
safety.
4. Organisation policies-related:
Defining, promoting awareness
of and ensuring implementation
of the policies and procedures
laid down by the organisation,
amongst staff, patients and
interested parties including
visiting medical consultants.
5. NABH Standards-related:
Identification of how the
organisation meets the NABH
standards and the objective
elements. Where a part of an
element, an element or a standard
cannot be applied (for example,
45
related to emergency, surgical
POLICYMAKER’S perspective
proceudres, laboratory services,
radiological services, etc) in a
particular organisation, adequate
explanation and justification
must be provided to NABH and
its team of assessors to enable
exclusion of applicability. In
particular, it must be ensured
that the intent of each chapter
of standards is understood and
applied.
Q How do you ensure compliance
by hospitals? What are the key
challenges?
NABH accreditation is based
on continuous improvement and
monitoring. Certificate is valid for
three years and there is a surveillance NABH accreditation is
assessment in 15-17 months. based on continuous
In addition, there is a surprise
check of one facility every month.
improvement
Further, there may be additional and monitoring.
surprise visits based on feedback Certificate is
from stakeholders. Continuous valid for three
monitoring to ensure compliance
and making hospitals to improve is years and there
a great challenge. Therefore, is a surveillance
providing education and training assessment in 15-17
opportunities are important for
hospitals to excel.
months. In addition,
there is a surprise
Q How do you help hospitals to
attain various quality standards
check of one facility
every month.
set by NABH?
We organise various training
programmes from time to time.
These may include training on
standards interpretation and
implementation, medication
management, infection prevention
and control, documentation
requirements, continuous
quality improvement, etc. In
addition, we also organise conclaves
for accredited hospitals and
awareness programmes for
potential applicants.
ehealth.eletsonline.com | JUly 2017
 46

IVH Enabling
industry perspective

an Integrated Tertiary
Care Ecosystem
India Virtual Hospital (IVH) is a tech-enabled integrated tertiary care
ecosystem addressing the needs of Medical Travellers (domestic and
international) looking for quality medical treatments in Indian hospitals
and healthcare centres. A professional organisation with doctors,
healthcare professionals, patient guides on board, IVH team is trained to
support and help patients to manage their medical and surgical care away
from home, says Swadeep Srivastava, Managing Partner & Founder, India
Virtual Hospital, in an interview with Elets News Network (ENN).

Q What are the challenges faced

by Patients going for Tertiary
Care Treatment?
There are numerous challenges
faced by patients especially medical
travellers (travelling to other city)
when they are advised for procedures/
operations. They are not aware of
the right treatment, right doctor,
right hospital and right cost. Most of
these queries are to get the right and
credible information due to acute lack
of trust on the existing referral system
or any credible system to help them
choose best of medical care. Every
month, several patients go back home
unsatisfied because of bad experience
in their patient journey.
“Information is power. IVH Patient
Education Series strive to create an
organised and professional process Swadeep
Srivastava
of ‘decision-making’ by empowering
patients with right and relevant
information in an unbiased and
neutral way and facilitating them at Managing Partner & Founder
every step for smooth and seamless India Virtual Hospital
patient care experience.”
Rai Umraopati Ray
Co-Founder & Lead, Patient Education, Care Champion (PCC) enrolled
India Virtual Hospital under our Expanded Patient Care
“There are glaring gaps in the patient Programme who works as a caregiver
care services that leave patients & to patients in their city. IVH PCP
their care at a disadvantage leading to is backed by our robust module of
sub optimal services and low patient
satisfaction level. The services of ‘patient education’ and counselling
India Virtual Hospital are game programme run by our in-house
changer in the healthcare industry doctors and patient counsellors.
of India as it empowers patients at
every stage of the patient’s journey.
The whole objective of IVH is to
provide seamless and smooth
experience to patient and its family
Q How do you decide on the
treatment cost and quality
members, right from the diagnosis to of services to be offered to a

Q How India Virtual Hospital is

making a difference?
treatment to follow-up stage.”
Dr Ravi Prakash
Medical Advisor, India Virtual Hospital
patient?

IVH has a policy to negotiate best

A medical traveller or his
family member has to just call us
at our health line number: 09999-
668-222, or visit our website www.
IndiaVirtualHospital.com, to inform
about their tertiary care treatment
requirement. Thereafter, the IVH
team takes over either through
tele-consultation or the Patient
“IVH has a robust technology along
with a state-of-art specially designed
Hybrid Mobile App which comes with
Dual Interface, one for the Channel
Partners/ IVH Patient Care Partners
and the second one for the Patients
& their Families.”
Gaurav Pandey
Co-Founder & Lead, IT & Technology,
India Virtual Hospital
with the tertiary care super-specialist
hospitals of all categories and offer
transparent costing to its consumers.
Since, our module is neutral so the
patients can make their own choice
to select what suits them the best.
IVH only plays the role of an expert
advisor.

JUly 2017 | ehealth.eletsonline.com

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 48

Indogulf
industry perspective

Hospital
Closing the Quality Gaps
in Global Healthcare
With an aim to serve the needy, Dr S Kumar is building 200-bedded
hospital with all diagnostic services including catheterisation
laboratory, blood bank and paramedical teaching institute in
Conakry, the capital and largest city of Guinea in West Africa. He
is also planning to have diagnostic and nursing homes in the
surrounding countries. In a conversation with Gautam Debroy of
Elets News Networks (ENN), the Managing Director of the Indogulf
Hospital, tells about his future plans and ongoing projects. Excerpts:

Dr S Kumar Managing Director

Indogulf Hospital

Q The Indogulf Hospital is

recognised as one of the best
hospitals in the National Capital
Region (NCR), what are your key
specialties?
The Indogulf Hospital started
diagnostic services in the year
2002 and was the first one to start
diagnostics in Noida, Uttar Pradesh.
Seven years ago, the hospital started
the indoor facility. We are providing
quality healthcare services and
ours is the best rated medium
sized hospital in the region. We are
providing specialised services in
neurology, obstetrics and gynecology
and orthopedics.
Q The hospital has made its
presence globally with a centre
in Guinea. Tell us more about it.
Most of the countries in Africa
are still under developed. The quality
of medical facilities being offered is
very poor and the patients have to
travel to other countries for quality
medical treatment. I am building a
200-bedded hospital in Conakry with
all the diagnostic services including
catheterisation laboratory, blood
bank and paramedical teaching
institute. It is one of a kind hospital in

JUly 2017 | ehealth.eletsonline.com


Guinea and other nearby countries.
I am grateful to Prof Alpha Conde,
President, Republic of Guinea, who
helped me to implement the project.
Q The First Lady of Sierra Leone,
Sia Nyama Koroma, recently
visited your hospital in Noida.
What was the result of her visit?
The First Lady of Sierra Leone, Sia
Nyama Koroma, visited the Indogulf
Hospital in Noida on our invitation.
She is very keen to develop a chain
of maternity centres and schools in
her country.
The First Lady was accompanied by
Madam Rahman Madina, Deputy
Health Minister of Sierra Leone and
other delegates. They came here
to have first hand information on
developing medical and educational
institutes. The aim of her visit was
also to meet prospective investors for
Sierra Leone particularly in sectors
like health, education, agriculture and
hospitality services.
She visited Indogulf Hospital, as it has
developed its brand identity as the
provider of quality medical services to
the rich as well as poor of the society.
Q What are the future plans of
Indogulf Hospital?
Yes, in the times to come I do
plan diagnostic and nursing homes
in the countries surrounding Guinea.
But for now, I am concentrating on
Sierra Leone.
Sierra Leone is one of the
Commonwealth countries. Dr
Ernest Bai Koroma is the President
49
industry perspective
The First Lady of
Sierra Leone, Sia
Nyama Koroma,
visited the Indogulf
Hospital in Noida on
our invitation. She is
very keen to develop
a chain of maternity
centres and schools
in her country.
of Republic of Sierra Leone and
he has initiated the country on the
path of development. His vision and
mission is to work for the upliftment
of his country with the help of
international support.
Sierra Leone needs serious medical
attention. The country has already
successfully put up a fight against
Ebola virus. Building hospital in
Sierra Leone will definitely serve the
people of neighbouring countries
as well.
Q What do you think about the
present healthcare system in
India?
The healthcare system in India
is rated as one of the best in the
world. There is a tremendous medical
tourism potential in India because
of affordable cost of treatment and
quality services almost at par with
developed countries.
ehealth.eletsonline.com | JUly 2017
 50

New Horizons
industry perspective

of Growth
for Indian Health
Startups
The National Health Policy 2017 is a positive step towards the
overall growth of the healthcare sector. With the government
planning to spend 2.5 per cent of the GDP on healthcare, Indian
health startups are set to reap huge benefits from this policy
initiative, says Krishnamurthy Ramalingam, CEO & MD, Galactic
Medical DataBank Private Limited, in conversation with Elets
News Network (ENN).

Krishnamurthy
Ramalingam
CEO & MD
Galactic Medical DataBank
Private Limited

Q How has been the Indian startup

ecosystem evolving recently?
What are the key challenges for
its growth?
The Indian startup ecosystem
is growing faster than in any other
country, thanks to the encouragement
by the government (both Central
and State), their policies, technology
business incubations in engineering
colleges, startup innovation cells at
management colleges, and private
players providing startup ecosystems
at nominal costs, etc.
The key challenges for the startups
are:
• Government’s policies should be
focused on job generation rather
than innovations to facilitate
emergence of startups that can
provide more employment
opportunities. Startup India Portal
(startupindia.gov.in) is a very
good initiative. But startups are
struggling to get registered on it
and get approval due to stringent
process of getting Innovation
certificate, Funding certificate, etc.
It should be simple like “Make in
Germany” initiative that allows

JUly 2017 | ehealth.eletsonline.com

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: rkmurthy318@gmdbcloud.co.in website: www.gmdbcloud.com
 52
industry perspective
anyone to start a company and get
the benefits as long as it generates
jobs.
• Startups should be given grants
to implement their solutions
at government institutions as
proof of concept so that the latest
technologies are available at
government institutions.
• Government can facilitate strategic
partnerships between startups and
multinational companies in all
government projects.
• Government procurement policy
should include startups in strategic
partnership with MNCs.
• Government should encourage
startups in conferences and
exhibitions by providing 100 per
cent discount for space, delegate
passes, and to pitch their products
at national and international level.
• Policy makers should involve
startup representatives in their
decision making processes so that
their problems are addressed.
Q How recent policy initiatives
like National Health Policy are
impacting healthcare startups
in India?
The National Health Policy 2017
is a very positive step with progressive
goals set across all areas of healthcare
sector. As the government plans to
spend 2.5 per cent of the GDP on
healthcare, health startups are set to
reap benefits from it, provided they
are supported in these ways:
• Private players, NGOs and non-
profit organisations are encouraged
to run primary, secondary and
tertiary health centres so that
remote areas in north-eastern
states and Union Territories
like Andaman and Nicobar and
Lakshadweep develop quality
healthcare delivery system.
• Free ecosystems are provided to
startups to develop bio-medical
devices, healthcare IT solutions,
JUly 2017 | ehealth.eletsonline.com
bio-pharma, organic farming, etc.
• To offer health insurance to
every citizen, like in Singapore,
so that in case of emergencies
the patients and their families do
not go bankrupt due to financial
constraint.
• Yoga and meditation centres are
run by non-profit organisations
at every hospital, school, college,
workplace, etc.
• Government makes it mandatory
for all hospitals and clinics – both
private and public – to go digital by
2020 by providing incentives like
the way it was done in the US.
• Policy to ensure that all
government officials including
MLAs, MPs, and ministers receive
treatment from government
hospitals only.
• Making it mandatory that within
12 hours of receiving request from
the patient, the healthcare provider
should provide the entire medical
history present with them to the
patient.
• Electronic medical record is made
a legal record to boost digital
health.
• Telemedicine and tele-consultation
encouraged at all levels.
• Tele-education and CME credits
should be made mandatory for
yearly renewal of licenses of both
nurses and physicians.
Q What role is Information
Technology (IT) playing in the
growth of startups in healthcare
space?
Healthcare IT startups are
trying to solve the problems faced
by healthcare organisations using
latest technologies and innovations.
Efficiency and proficiency of
healthcare providers are improved
with the healthcare IT solutions by
startups. Innovative, cost effective,
qualitative and disruptive solutions
are replacing the old legacy
systems. Physical storage spaces
Healthcare IT
startups are
trying to solve the
problems faced
by healthcare
organisations using
latest technologies
and innovations.
Efficiency and
proficiency
of healthcare
providers are
improved with
the healthcare
IT solutions by
startups.
for maintaining medical records
are saved because of electronic
medical record. Insurance claims
and reimbursements have been made
faster and convenient for claimants.
Patients are able to get medicines
at their doorsteps using e-medicine
portals. Assisted health professionals
services can be made available at
home through portals which are
really transforming the healthcare
sector for elderly and palliative
patients.
Q Which areas in healthcare sector
hold the potential for growth?
Health IT software and
services, affordable medical devices,
bio-pharma, medical insurance,
healthcare services, pharmacy chains,
diagnostics centres, homecare, etc are
some of the areas for potential growth
in India.
 54

Axio
industry perspective

Biosolutions
Saving Lives
Through Innovations
Axio Biosolutions Pvt Ltd is an ISO 13485 certified company with an
experienced team focused on bringing high-impact medical products
to market. Funded by Accel Partners, IDG Ventures India and Gujarat
Venture Finance Ltd, Axio is currently present in 12 countries and is the
only company in India to produce this kind of products. Chairman of the
Board and CEO of Axio Biosolutions Leo S Mavely, shares his company’s
USP, the market experience and future plans, in conversation with T.
Radhakrishna of Elets News Network (ENN).

interventional cardiology/radiology) Axio Biosolutions currently

and Dental (dental dressing – stop
oral bleeding, protect wound). The
excerpts of the interview with its
CEO:
offers four unique products catering
to emergency, military, vascular and
dental markets
Emergency: Axiostat is a sterile,

Q What is your USP and your single-use, non-absorbable

Leo S
promise to users? haemostatic dressing intended to
be used for temporary control of
Wounds cause suffering, pain, bleeding wounds. It stops moderate

Mavely long hospital stays, morbidity and

Chairman of the Board and
CEO of Axio Biosolutions
even death. Our promise to users is:
Axio Products help stop bleeding for
first 24 hours from the time applied.
Our focus is stop bleeding Saves
lives. We started on the premise that
to severe bleeding due to cuts,
abrasions, lacerations, venous or
arterial bleeding. The product can
stop haemorrhage from actively
bleeding vessels within minutes. It
is ready to use and can be cut to suit

A
xio Biosolutions Pvt Ltd is
the first medi-tech company
from India to design, develop
and commercialise products for
Emergency (emergency bleeding
control, stop haemorrhage), Military
(chitosan sponge for quick clot –
haemostatic dressing), Vascular
(vascular haemostatic dressing for
most of these are preventable. We
demonstrated that it is possible. We
believe in solving such primal issues
through innovative use of technology.
We invent and create such tech. We
do not follow. We lead.
Q Would you share about your
products and organisation’s
vision?
different wound sizes. They can be
delivered through a pool of blood and
is simple to apply and remove by a
non- medical first responder.
Military: Axiostat Military variant
MIL88 is designed to be used in
battlefield conditions and comes in
camouflaged, rugged metal pouch
packing for easy carrying. It is

JUly 2017 | ehealth.eletsonline.com


currently used by Defense Forces,
Paramilitary Forces and Army across
India, Middle East and Europe.
MIL88 is capable of being folded and
stuffed into deep wounds. MIL88
uses a.c.t. which is battlefield proven
technology to achieve hemostasis in
a easier and quicker way. The product
and technology assists fprces to stop
profuse bleeding caused due to on
field calamities.
Vascular: Cardiac patients are often
at high-risk of uncontrolled bleeding
due to the blood thinners that are
administered prior to catheterisation
procedures. Not any more. Axiostat
Vascular dressing is proven to be a
very effective and efficient means of
stopping bleeding during Vascular
procedures when compared to
traditional compression methods that
can take upto 30 minutes. Axiostat
also eliminates the chances of re-
bleeding after achieving haemostasis
in vascular procedures available
in multiple sizes. V55, especially
designed with measured thickness to
stop heavy volume of blood during
the interventional procedures.
Dental: Axiostat Dental variant,
specially designed to control severe
bleeding during dental procedures.
Often difficult to reach, dental
bleeding can quickly become
uncontrolled and unmanageable.
Our smallest offering designed to
optimally fit into the bleeding cavity.
Effective on oral mucosal tissue
wounds. Fast action to control
bleeding. Active on all sides. Protects
wound area. Easy removal using
water/saline.
Vision of Axio is to develop
affordable, high impact medical
products that can solve unmet
healthcare needs of emerging
markets. Controlling life-threatening
bleeding continues to be the major
cause of death from traumatic
injuries.
Q Highlight your technologies used
for making unique products?
Axiostat uses a.c.t (axio clotting
technology) to control severe
haemorrhage within minutes. a.c.t
is based on a biopolymer platform
that utilises cationic properties for
medical applications.
Process Innovation: Chitosan has
been in use for medical application
since beginning of 21st century.
However, major challenges associated
with chitosan based products are
lack of consistency and presence of
impurities. Axio uses a proprietary
technology to filter, purify chitosan
and result is end products without
any variation in performance or
safety features. Particularly Axio
technology uses low polydispersity,
high molecular weight raw material
with a very pure, 100% chitosan,
55
industry perspective
quick-acting Haemostat.
Axio products are constantly
benchmarked with global harmonised
standards and starting material,
chitosan complies with the ASTM
standard and are made in ISO 13485
approved facilities.
Characterstics of Chitosan are
Biocompatible; Bioadhesive; 100%
Natural; 0% Protein; No exothermic
reaction; and Easily broken down to
glucosamine.
Q How significant are your R&D,
Manufacturing and Quality
resources and practices?
R&D: Axio Biosolutions envisages
a future where contemporary
knowledge of biomaterials, medicine
and engineering will be integrated
in designing novel solutions to
address the huge unmet need in
management of trauma and chronic-
infectious wounds.
We are a deep science med-tech
company with extensive R&D
expertise in biomaterials. Our
platform-based approach enables us
to develop medical products that are
engineered to enhance its efficacy even
at higher scale. With such a vision, we
introduced our first line of haemostatic
products that are probably one of the
best available trauma heamostats in
the market today.
ehealth.eletsonline.com | JUly 2017
 56
industry perspective
Axio’s research philosophy is to
translate the biomaterials research
into real-world products and bring
them to patients’ bedside at an
affordable cost. Here, innovation
is a daily practice as we explore
unchartered territories in novel
materials and technologies. The
research & development team at Axio
is developing novel solutions that are
smarter, friendlier and quicker than
the conventional products.
Manufacturing Facility: Axio
products are manufactured in ISO
13845 certified facility owned and
operated by Axio.
• State of the art manufacturing
facility is located in Pharma Tech
Park at Ahmedabad, Gujarat.
• Custom built imported machinery
with 75-80% automated
processing. Minimal human
intervention reducing handling
errors.
• 5,000 sq.ft cleanroom area
built according to cGMP, FDA
guidelines under Class 10000
manufacturing area.
• Gamma sterilisation done
terminally. Full traceability from
finished product to raw material
source.
• All 3rd party vendors audited and
qualified by EU notifying body.
Axio is an equal opportunity
employer with commitment to equal
treatment of all employees without
regard to race, origin, religion,
gender, age, sexual orientation,
physical or mental disability or other
basis protected by law.
Axio ensures and complies
with environmental policies for
manufacturing facility of medical
devices. No hazardous, polluting
effluents are discharged into the
environment. Proper handling and
disposal of industrial waste is in
compliance with local law.
JUly 2017 | ehealth.eletsonline.com
Quality: We, at Axio, benchmark
ourselves to global standards and
follow appropriate regulatory
guidelines in respective countries of
operation. We follow a process that
is based on a strong foundation of
manufacturing quality standards,
mutually beneficial relations with
our customers, dealers and all
professionals associated with us.
• Audited and certified by European
Notifying Body – Det Norske
Veritas (DNV), Norway.
• Dedicated In-house Quality R&D
with specialized equipments for
testing.
• Expert QA and QC team who
has undergone rigorous ISO
13485 internal auditor training
programmes
Q What promoted you to the idea
of Axio Biosolutions in you?
In 2006, I came across an
incident in which a bus badly injured
a motorbiker in Delhi. He was
profusely bleeding and I felt helpless
to stop his bleeding. But I managed to
take him to the hospital in time and
he survived. I strongly felt the need
of a product to stop high bleeding
and save lives. I failed to come across
something that could stop such a
bleeding instantly. First responders
only used gauze with high pressure,
which is not enough for severe
accident victims.
Axio’s flagship product Axiostat is
a ‘Smart Bandage’ that helps stop
profuse bleeding within minutes.
It is manufactured in their plant in
Ahmedabad.
I started Axio Biosolutions in
Nirma Labs in 2008. It’s a start-up
incubator to develop a product that
can immediately stop bleeding and
give a patient a few more hours and a
chance to survive.
Funded by Accel
Partners, IDG
Ventures India and
Gujarat Venture
Finance Ltd, Axio
Biosolutions is
currently present
in 12 countries and
is the only company
in India to produce
this kind of unique
products.
It is manufactured on a novel
biomaterial platform, based on 100%
chitosan — a natural biomaterial
modied for medical application.
The technology works on charge
interactions between negatively
charged blood components and
positively charged Axiostat.
Q What has been your market
experience? What about your
future plans?
Since our inception in 2008,
our experience with Indian market
is extremly encouraging. Today, we
work with Indian Defence Units and
we have presence in 12 International
markets through country sales
partners. We also work with top
100 hospital groups in India. We are
focusing on increasing manufacturing
capacity to 800,000 and 10,00,000
capacity units.
Our future plans include: to bring
out a next level of advanced first
aid kits for automotive companies
in India and globally where our
products are part of the kits; expand
our foot print globally; and bring out
new products;
 57

Universal Hospitals
Where Quality Matters
Accredited by Joint Commission International, the gold standard in
global quality healthcare, and the winner of prestigious Sheikh Khalifa
Excellence Award 2016 (SKEA), Universal Hospitals follows the principles
of total quality management and continuous quality improvement, says
Dr Shabeer Nellikode, Managing Director, Universal Hospitals, Abu Dhabi,
in an interview with Elets News Network (ENN).

Commission International, the gold continues to get updated to current

standard in global quality healthcare
and has also won the prestigious Sheikh
Khalifa Excellence Award 2016 (SKEA
2016) for continuous improvement
aimed at enhancing the competitiveness
HIMSS standards on a daily basis. This
has given us tremendous flexibility
in modifying, shaping up business
processes to meet changing regulatory
needs. The recent announcement of

Dr Shabeer
of the business sector in Abu Dhabi and shrinking the claim submission window
the UAE. to 24 hrs is such a regulatory shift.
Because of our in house IT system we
Nellikode We work on the principles of total were able to meet this target without
Managing Director quality management and continuous any major shift in business.
Universal Hospitals, Abu Dhabi quality improvement.
Further this gives us the flexibility

Q What are the key healthcare

services offered by your hospital?
How do you ensure quality?  a voice through complaints systems or
Universal Hospitals offers multispecialty
tertiary care with medical expertise
and technological capabilities at its
core. The key healthcare services being
offered include minimal access surgery,
aeronautical and aerospace medicine,
specialty clinics, treatment for high risk
and critical cases, complex surgeries,
recurrent, reconstructive and revision
surgeries, non-invasive treatment for
RF Ablation of thyroid tumours, liver
tumours, kidney tumours, beningn
thyroid nodules, lung tumours, etc.
The hospital also offers 24-hour
emergency services, robotic pharmacy
and advanced radiology services. We
have a state-of-the-art laboratory and
over 18 multispecialty departments
with state-of-the-art facilities.
Universal Hospital is accredited by Joint
We also empower patients and make
them aware of their rights giving them
patient satisfaction surveys, as well as
publicising what patients can expect.
Q How is Information Technology
bringing efficiency to your
operations?
Much like in any modern industry
Information Technology is the critical
back bone of the service delivery
process. More so in the Healthcare
space because no clinical decision
can be made in real time if the right
information is not available to the right
care provider for the right patient in
real time. Considering the importance
of this we have taken the dual challenge
of not only developing healthcare
infrastructure but also developing
Healthcare IT platform in house.
Our EMR has been created from
scratch by an internal team and
to evolve to accommodate newer
diagnostic modalities, newer care
processes with seamless flexibility.
We have also gone ahead and developed
our own ERP back bone with helps in
business process restructuring to bring
in lean principles in procurement and
continuous quality improvement.
Q Which innovations you seek
to introduce in your hospital to
improve healthcare delivery to
patients?
Dedicating beds for end-of-life
patients within a hospice inpatient
unit, smart rehabilitation at home
before and after surgery, post-operative
pathways to meet individual need,
patient centric approach to health and
social care integration and adoption
of robotic technology to improve
patient car are some of the areas we
are working on to improve healthcare
delivery to patients.

ehealth.eletsonline.com | JUly 2017

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